Metadata
Title | Appropriate Testing for PharyngitisFHIR
Version | 1.0.000
Short Name | CMS146FHIR
GUID (Version Independent) | urn:uuid:9012731d-f909-4733-aca5-b14e66fe9acd
GUID (Version Specific) | urn:uuid:f5065d63-f2b7-438c-b677-14862bdecd27
CMS Identifier | 146FHIR
Effective Period | 2026-01-01 through 2026-12-31
Steward (Publisher) | National Committee for Quality Assurance
Developer | National Committee for Quality Assurance
Description | The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order on or three days after the episode date and a group A streptococcus (strep) test in the seven-day period from three days prior to the episode date through three days after the episode date
Copyright | This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.
Disclaimer | The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Rationale | Group A streptococcal (GAS) bacterial infections and other infections that cause pharyngitis (which are most often viral) often produce the same signs and symptoms (Shulman et al., 2012). The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the Infectious Diseases Society of America all recommend a diagnostic test for Strep A to improve diagnostic accuracy and avoid unnecessary antibiotic treatment (Linder et al., 2005). Estimated economic costs of pediatric streptococcal pharyngitis in the United States range from $224 million to $539 million per year, including indirect costs related to parental work losses. At a higher level, the economic cost of antibiotic resistance varies but has extended as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (2008 dollars) (Pfoh et al., 2008).
Clinical Recommendation Statement | Infectious Disease Society of America (Shulman et al., 2012) The Infectious Diseases Society of America "recommends swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present"
Citation | Linder, J. A., Bates, D. W., Lee, G. M., et al. (2005). Antibiotic Treatment of Children with Sore Throat. JAMA, 294(18), 2315-2322.
Citation | Pfoh, E., Wessels, M.R., Goldmann, D., et al. (2008). Burden and Economic Cost of Group A Streptococcal Pharyngitis. Pediatrics, 121(2), 229-234. doi: 10.1542/peds.2007-0484
Citation | Shulman, S. T., Bisno, A. L., Clegg, H. W., et al. (2012). Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 55(10), E86-E102. doi:10.1093/cid/cis629
Guidance (Usage) | This is an episode of care measure that examines all eligible episodes for the patient. The intent is to determine whether antibiotics are being ordered appropriately. Antibiotics should only be ordered if a strep test has been performed to confirm a bacterial infection. Antibiotics should not be ordered for viral infections. Antibiotics should be ordered on or three days after the episode date. This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order from January 1 to December 28 of the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS146v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
Measure Group (Rate) (ID: Group_1)
Basis | Encounter
Scoring | [http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']
Type | [http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']
Rate Aggregation | None
Improvement Notation | [http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']
Initial Population | ID: InitialPopulation_1 Description: Outpatient, telephone, virtual encounter (i.e., e-visit or virtual check-in), or emergency department (ED) visits with a diagnosis of pharyngitis or tonsillitis from January 1 to December 28 of the measurement period and an antibiotic order on or three days after the episode date among patients 3 years or older Logic Definition: Initial Population
Denominator | ID: Denominator_1 Description: Equals Initial Population Logic Definition: Denominator
Denominator Exclusion | ID: DenominatorExclusion_1 Description: Exclude pharyngitis episodes when the patient had hospice care for any part of the measurement period. Exclude pharyngitis episodes when the patient had a comorbid condition during the 12 months prior to or on the episode date. Exclude pharyngitis episodes where the patient is taking antibiotics in the 30 days prior to the episode date. Exclude pharyngitis episodes where the patient had a competing diagnosis on or three days after the episode date. Logic Definition: Denominator Exclusions
Numerator | ID: Numerator_1 Description: A group A streptococcus test in the seven-day period from three days prior to the episode date through three days after the episode date Logic Definition: Numerator
Stratifier | ID: Stratification_1_1 Description: - 3-17 years
Stratifier | ID: Stratification_1_2 Description: - 18-64 years
Stratifier | ID: Stratification_1_3 Description: - 65 years and older
Supplemental Data Guidance | For every patient evaluated by this measure also identify payer, race, ethnicity and sex
Supplemental Data Elements
Supplemental Data Element | ID: sde-ethnicity Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Ethnicity Logic Definition: SDE Ethnicity
Supplemental Data Element | ID: sde-payer Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Payer Logic Definition: SDE Payer
Supplemental Data Element | ID: sde-race Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Race Logic Definition: SDE Race
Supplemental Data Element | ID: sde-sex Usage Code: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data] Description: SDE Sex Logic Definition: SDE Sex
Measure Logic
Primary Library | https://madie.cms.gov/Library/CMS146FHIRApproTestPharyngitis
Contents | Population Criteria Logic Definitions Terminology Dependencies Data Requirements
Population Criteria
Measure Group (Rate) (ID: Group_1)
Initial Population
    define "Initial Population":
      "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
        where AgeInYearsAt(date from start of "Measurement Period") >= 3
        return EncounterWithPharyngitis
Denominator
    define "Denominator":
      "Initial Population"
Denominator Exclusion
    define "Denominator Exclusions":
      "Encounters and Assessments with Hospice Patient"
        union Antibiotic."Encounter with Comorbid Condition History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [ConditionEncounterDiagnosis: "Comorbid Conditions for Respiratory Conditions"] ).verified ( ) )
        union Antibiotic."Encounter with Antibiotic Medication History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [MedicationRequest: "Antibiotic Medications for Pharyngitis"] ).isMedicationActive ( ) )
        union Antibiotic."Encounter with Competing Diagnosis History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [ConditionEncounterDiagnosis: "Competing Conditions for Respiratory Conditions"] ).verified ( ) )
Numerator
    define "Numerator":
      from
        "Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
        "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
        where GroupAStreptococcusTest.effective.toInterval ( ) starts during day of Interval[( end of EncounterWithPharyngitis.period ) - 3 days, ( end of EncounterWithPharyngitis.period ) + 3 days]
        return EncounterWithPharyngitis
Stratifier
    define "Encounter With Pharyngitis or Tonsillitis With Antibiotic":
      from
        "Encounter With Antibiotic Ordered Within Three Days" VisitWithAntibiotic,
        "Pharyngitis or Tonsillitis" AcutePharyngitisTonsillitis
        where AcutePharyngitisTonsillitis.prevalenceInterval ( ) starts during day of VisitWithAntibiotic.period
        return VisitWithAntibiotic
Stratifier
    define "Encounter With Pharyngitis or Tonsillitis With Antibiotic":
      from
        "Encounter With Antibiotic Ordered Within Three Days" VisitWithAntibiotic,
        "Pharyngitis or Tonsillitis" AcutePharyngitisTonsillitis
        where AcutePharyngitisTonsillitis.prevalenceInterval ( ) starts during day of VisitWithAntibiotic.period
        return VisitWithAntibiotic
Stratifier
    define "Encounter With Pharyngitis or Tonsillitis With Antibiotic":
      from
        "Encounter With Antibiotic Ordered Within Three Days" VisitWithAntibiotic,
        "Pharyngitis or Tonsillitis" AcutePharyngitisTonsillitis
        where AcutePharyngitisTonsillitis.prevalenceInterval ( ) starts during day of VisitWithAntibiotic.period
        return VisitWithAntibiotic
Logic Definitions
Logic Definition | Library Name: Hospice
    define "Has Hospice Services":
      exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
          where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
              or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
          )
            and InpatientEncounter.period ends during day of "Measurement Period"
      )
        or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
            where HospiceEncounter.period overlaps day of "Measurement Period"
        )
        or exists ((([ObservationScreeningAssessment: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
            where HospiceAssessment.value ~ "Yes (qualifier value)"
              and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
        )
        or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
            where HospiceOrder.authoredOn during day of "Measurement Period"
        )
        or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
            where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
        )
        or exists ((([ConditionProblemsHealthConcerns: "Hospice Diagnosis"]
            union [ConditionEncounterDiagnosis: "Hospice Diagnosis"]).verified()) HospiceCareDiagnosis
            where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
        )
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Sex":
      case
        when Patient.sex = '248153007' then "Male (finding)"
        when Patient.sex = '248152002' then "Female (finding)"
        else null
      end
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Payer":
      [Coverage: type in "Payer Type"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Ethnicity":
      Patient.ethnicity E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }
Logic Definition | Library Name: SupplementalDataElements
    define "SDE Race":
      Patient.race R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "SDE Sex":
      SDE."SDE Sex"
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Group A Streptococcus Lab Test With Result":
      ( ( [LaboratoryResultObservation: "Group A Streptococcus Test"] ).isLaboratoryTestPerformed ( ) ) GroupAStreptococcusTest
        where GroupAStreptococcusTest.value is not null
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Qualifying Encounters":
      ( ( [Encounter: "Emergency Department Evaluation and Management Visit"]
          union [Encounter: "Home Healthcare Services"]
          union [Encounter: "Medical Disability Exam"]
          union [Encounter: "Office Visit"]
          union [Encounter: "Telephone Visits"]
          union [Encounter: "Virtual Encounter"]
          union [Encounter: "Outpatient Consultation"]
          union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]
          union [Encounter: "Preventive Care Services Group Counseling"]
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ "Unlisted preventive medicine service"
              )
          )
          union [Encounter: "Preventive Care Services, Initial Office Visit, 0 to 17"]
          union [Encounter: "Preventive Care Services Individual Counseling"]
          union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]
          union [Encounter: "Preventive Care, Established Office Visit, 0 to 17"]
      ).isEncounterPerformed ( ) ) ValidEncounter
        where ValidEncounter.period ends during day of Interval[( start of "Measurement Period" ), ( end of "Measurement Period" ) - 3 days]
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Encounter With Antibiotic Ordered Within Three Days":
      "Qualifying Encounters" EDOrAmbulatoryVisit
        with ( ( [MedicationRequest: "Antibiotic Medications for Pharyngitis"] ).isMedicationOrder ( ) ) AntibioticOrdered
          such that EDOrAmbulatoryVisit.period.toInterval ( ) starts 3 days or less on or before day of AntibioticOrdered.authoredOn
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Pharyngitis or Tonsillitis":
      ( [ConditionEncounterDiagnosis: "Acute Pharyngitis"]
          union [ConditionEncounterDiagnosis: "Acute Tonsillitis"]
      ).verified ( )
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Encounter With Pharyngitis or Tonsillitis With Antibiotic":
      from
        "Encounter With Antibiotic Ordered Within Three Days" VisitWithAntibiotic,
        "Pharyngitis or Tonsillitis" AcutePharyngitisTonsillitis
        where AcutePharyngitisTonsillitis.prevalenceInterval ( ) starts during day of VisitWithAntibiotic.period
        return VisitWithAntibiotic
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Numerator":
      from
        "Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
        "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
        where GroupAStreptococcusTest.effective.toInterval ( ) starts during day of Interval[( end of EncounterWithPharyngitis.period ) - 3 days, ( end of EncounterWithPharyngitis.period ) + 3 days]
        return EncounterWithPharyngitis
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Initial Population":
      "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
        where AgeInYearsAt(date from start of "Measurement Period") >= 3
        return EncounterWithPharyngitis
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Denominator":
      "Initial Population"
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "SDE Payer":
      SDE."SDE Payer"
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "SDE Ethnicity":
      SDE."SDE Ethnicity"
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Encounters and Assessments with Hospice Patient":
      "Initial Population" EligibleEncounters
        where Hospice."Has Hospice Services"
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "Denominator Exclusions":
      "Encounters and Assessments with Hospice Patient"
        union Antibiotic."Encounter with Comorbid Condition History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [ConditionEncounterDiagnosis: "Comorbid Conditions for Respiratory Conditions"] ).verified ( ) )
        union Antibiotic."Encounter with Antibiotic Medication History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [MedicationRequest: "Antibiotic Medications for Pharyngitis"] ).isMedicationActive ( ) )
        union Antibiotic."Encounter with Competing Diagnosis History" ( "Encounter With Pharyngitis or Tonsillitis With Antibiotic", ( [ConditionEncounterDiagnosis: "Competing Conditions for Respiratory Conditions"] ).verified ( ) )
Logic Definition | Library Name: CMS146FHIRApproTestPharyngitis
    define "SDE Race":
      SDE."SDE Race"
Logic Definition | Library Name: FHIRHelpers
    define function ToString(value uri): value.value
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
    */
    define function ToConcept(concept FHIR.CodeableConcept):
        if concept is null then
            null
        else
            System.Concept {
                codes: concept.coding C return ToCode(C),
                display: concept.text.value
            }
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
    */
    define function ToCode(coding FHIR.Coding):
        if coding is null then
            null
        else
            System.Code {
              code: coding.code.value,
              system: coding.system.value,
              version: coding.version.value,
              display: coding.display.value
            }
Logic Definition | Library Name: FHIRHelpers
    /*
    @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
    value to a CQL DateTime Interval
    @comment: If the start value of the given period is unspecified, the starting
    boundary of the resulting interval will be open (meaning the start of the interval
    is unknown, as opposed to interpreted as the beginning of time).
    */
    define function ToInterval(period FHIR.Period):
        if period is null then
            null
        else
            if period."start" is null then
                Interval(period."start".value, period."end".value]
            else
                Interval[period."start".value, period."end".value]
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
    @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
    to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
    representations for timing-valued elements in QICore, allowing this function to be used across any resource.
    The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
    The intent of this function is to provide a clear and concise mechanism to treat single
    elements that have multiple possible representations as intervals so that logic doesn't have to account
    for the variability. More complex calculations (such as medication request period or dispense period
    calculation) need specific guidance and consideration. That guidance may make use of this function, but
    the focus of this function is on single element calculations where the semantics are unambiguous.
    If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
    If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
    and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
    If the input is a DateTime Interval, the result is the input.
    If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
    is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
    immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
    If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
    */
    define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
      case
    	  when choice is DateTime then
        	Interval[choice as DateTime, choice as DateTime]
    		when choice is Interval<DateTime> then
      		choice as Interval<DateTime>
    		when choice is Quantity then
    		  Interval[Patient.birthDate + (choice as Quantity),
    			  Patient.birthDate + (choice as Quantity) + 1 year)
    		when choice is Interval<Quantity> then
    		  Interval[Patient.birthDate + (choice.low as Quantity),
    			  Patient.birthDate + (choice.high as Quantity) + 1 year)
    		when choice is Timing then
          Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
    		else
    			null as Interval<DateTime>
    	end
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns an interval representing the normalized prevalence period of a given Condition.
    @comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
    onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting
    interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
    */
    define fluent function prevalenceInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
    if condition.clinicalStatus ~ "active"
      or condition.clinicalStatus ~ "recurrence"
      or condition.clinicalStatus ~ "relapse" then
      Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
    else
        (end of condition.abatementInterval()) abatementDate
        return if abatementDate is null then
          Interval[start of condition.onset.toInterval(), abatementDate)
        else
          Interval[start of condition.onset.toInterval(), abatementDate]
Logic Definition | Library Name: QICoreCommon
    /*
    @description: Returns an interval representing the normalized abatement of a given Condition.
    @comment: If the abatement element of the Condition is represented as a DateTime, the result
    is an interval beginning and ending on that DateTime.
    If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
    result is an interval from the date the patient turned that age to immediately before one year later.
    If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
    which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
    before one year later than the date the patient turned the ending age of the quantity interval.
    */
    define fluent function abatementInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
    	if condition.abatement is DateTime then
    	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
    	else if condition.abatement is Quantity then
    		Interval[Patient.birthDate + (condition.abatement as Quantity),
    			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
    	else if condition.abatement is Interval<Quantity> then
    	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
    		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
    	else if condition.abatement is Interval<DateTime> then
    	  Interval[condition.abatement.low, condition.abatement.high)
    	else null as Interval<DateTime>
Logic Definition | Library Name: CumulativeMedicationDuration
    define fluent function medicationRequestPeriod(Request "MedicationRequest"):
      Request R
        let
          dosage: singleton from R.dosageInstruction,
          doseAndRate: singleton from dosage.doseAndRate,
          timing: dosage.timing,
          frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
          period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
          doseRange: doseAndRate.dose,
          doseQuantity: doseAndRate.dose,
          dose: Coalesce(end of doseRange, doseQuantity),
          dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
          boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
          daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
          quantity: R.dispenseRequest.quantity,
          refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
          startDate:
            Coalesce(
              date from start of boundsPeriod,
              date from R.authoredOn,
              date from start of R.dispenseRequest.validityPeriod
            ),
          totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
        return
          if startDate is not null and totalDaysSupplied is not null then
            Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
          else if startDate is not null and boundsPeriod."high" is not null then
            Interval[startDate, date from end of boundsPeriod]
          else
            null
Logic Definition | Library Name: CumulativeMedicationDuration
    /**********************************************************************/
    /* Functions in this region are copied from opioid-mme-r4             */
    /**********************************************************************/

    define function Quantity(value Decimal, unit String):
      if value is not null then
        System.Quantity { value: value, unit: unit }
      else
        null
Logic Definition | Library Name: CumulativeMedicationDuration
    /*
     Goal is to get to number of days
     Two broad approaches to the calculation:
      1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
      2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
    This topic covers several use cases and illustrates how to calculate Cumulative
    Medication Duration for each type of medication resource using the supply and
    frequency approach.
    */

    /*
      For the first approach, we need to get from frequency to a frequency/day
      So we define ToDaily
    */

    /*
      Calculates daily frequency given frequency within a period
    */
    define function ToDaily(frequency System.Integer, period System.Quantity):
      case period.unit
        when 'h' then frequency * (24.0 / period.value)
        when 'min' then frequency * (24.0 / period.value) * 60
        when 's' then frequency * (24.0 / period.value) * 60 * 60
        when 'd' then frequency * (24.0 / period.value) / 24
        when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
        when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hour' then frequency * (24.0 / period.value)
        when 'minute' then frequency * (24.0 / period.value) * 60
        when 'second' then frequency * (24.0 / period.value) * 60 * 60
        when 'day' then frequency * (24.0 / period.value) / 24
        when 'week' then frequency * (24.0 / period.value) / (24 * 7)
        when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hours' then frequency * (24.0 / period.value)
        when 'minutes' then frequency * (24.0 / period.value) * 60
        when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
        when 'days' then frequency * (24.0 / period.value) / 24
        when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
        when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
      end
Logic Definition | Library Name: Status
    //Laboratory Test, Performed
    define fluent function isLaboratoryTestPerformed(Obs List<LaboratoryResultObservation>):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }
Logic Definition | Library Name: Status
    //Encounter, Performed
    //General usage unless required otherwise by measure intent (e.g., follow-up encounters)
    define fluent function isEncounterPerformed(Enc List<Encounter>):
      Enc E
        where E.status = 'finished'
Logic Definition | Library Name: Status
    //Medication, Order
    define fluent function isMedicationOrder(MedicationRequest List<MedicationRequest>):
      MedicationRequest M
        where M.status in { 'active', 'completed' }
        and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Status
    //This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.

    //Condition
    //Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
    define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):
      conditions C
        where C.verificationStatus is not null implies
          (C.verificationStatus ~ "confirmed"
            or C.verificationStatus ~ "unconfirmed"
            or C.verificationStatus ~ "provisional"
            or C.verificationStatus ~ "differential"
          )
Logic Definition | Library Name: Status
    //Assessment, Performed
    define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }
Logic Definition | Library Name: Status
    //Intervention, Order
    define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
      ServiceRequest S
        where S.status in { 'active', 'completed' }
          and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Status
    //Intervention, Performed
    define fluent function isInterventionPerformed(Proc List<Procedure>):
      Proc P
        where P.status ~ 'completed'
Logic Definition | Library Name: Status
    //Medication, Active
    define fluent function isMedicationActive(MedicationRequest List<MedicationRequest>):
      MedicationRequest M
        where M.status = 'active'
          and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}
Logic Definition | Library Name: Antibiotic
    define function "Encounter with Comorbid Condition History"(episodes List<Encounter>, comorbidConditions List<ConditionEncounterDiagnosis>):
      episodes episode
          with comorbidConditions comcondition
            such that date from start of comcondition.prevalenceInterval() during Interval[date from start of episode.period - 1 year, date from start of episode.period]
          return episode
Logic Definition | Library Name: Antibiotic
    define function "Encounter with Antibiotic Medication History"(episodes List<Encounter>, antibioticMedications List<MedicationRequest>):
       episodes episode
        with antibioticMedications ActiveMedication
          such that ActiveMedication.medicationRequestPeriod() overlaps day of Interval[date from start of episode.period  - 30 days, date from start of episode.period - 1 day]
Logic Definition | Library Name: Antibiotic
    define function "Encounter with Competing Diagnosis History"(episodes List<Encounter>, competingConditions List<ConditionEncounterDiagnosis>):
      episodes episode
          with competingConditions competcondition
            such that competcondition.prevalenceInterval() starts 3 days or less on or after day of start of episode.period
          return episode
Terminology
Code System | Description: Code system SNOMEDCT Resource: http://snomed.info/sct Canonical URL: `http://snomed.info/sct`
Code System | Description: Code system CPT Resource: http://www.ama-assn.org/go/cpt Canonical URL: `http://www.ama-assn.org/go/cpt`
Code System | Description: Code system ConditionVerificationStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-ver-status Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Code System | Description: Code system LOINC Resource: http://loinc.org Canonical URL: `http://loinc.org`
Code System | Description: Code system ConditionClinicalStatusCodes Resource: http://terminology.hl7.org/CodeSystem/condition-clinical Canonical URL: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Value Set | Description: Value set Group A Streptococcus Test Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1012 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1012`
Value Set | Description: Value set Emergency Department Evaluation and Management Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010`
Value Set | Description: Value set Home Healthcare Services Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016`
Value Set | Description: Value set Medical Disability Exam Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1073 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1073`
Value Set | Description: Value set Office Visit Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001`
Value Set | Description: Value set Telephone Visits Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080`
Value Set | Description: Value set Virtual Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089`
Value Set | Description: Value set Outpatient Consultation Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008`
Value Set | Description: Value set Preventive Care Services Established Office Visit, 18 and Up Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025`
Value Set | Description: Value set Preventive Care Services Group Counseling Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027`
Value Set | Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17 Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022`
Value Set | Description: Value set Preventive Care Services Individual Counseling Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026`
Value Set | Description: Value set Preventive Care Services Initial Office Visit, 18 and Up Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023`
Value Set | Description: Value set Preventive Care, Established Office Visit, 0 to 17 Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024`
Value Set | Description: Value set Antibiotic Medications for Pharyngitis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1001 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1001`
Value Set | Description: Value set Acute Pharyngitis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011`
Value Set | Description: Value set Acute Tonsillitis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1012 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1012`
Value Set | Description: Value set Payer Type Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591`
Value Set | Description: Value set Encounter Inpatient Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307`
Value Set | Description: Value set Hospice Encounter Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003`
Value Set | Description: Value set Hospice Care Ambulatory Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584`
Value Set | Description: Value set Hospice Diagnosis Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165`
Value Set | Description: Value set Comorbid Conditions for Respiratory Conditions Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1025 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1025`
Value Set | Description: Value set Competing Conditions for Respiratory Conditions Resource: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1017 Canonical URL: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1017`
Direct Reference Code | Display: Male (finding) Code: 248153007 System: `http://snomed.info/sct`
Direct Reference Code | Display: Female (finding) Code: 248152002 System: `http://snomed.info/sct`
Direct Reference Code | Display: Unlisted preventive medicine service Code: 99429 System: `http://www.ama-assn.org/go/cpt`
Direct Reference Code | Display: confirmed Code: confirmed System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: unconfirmed Code: unconfirmed System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: provisional Code: provisional System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: differential Code: differential System: `http://terminology.hl7.org/CodeSystem/condition-ver-status`
Direct Reference Code | Display: Discharge to home for hospice care (procedure) Code: 428361000124107 System: `http://snomed.info/sct`
Direct Reference Code | Display: Discharge to healthcare facility for hospice care (procedure) Code: 428371000124100 System: `http://snomed.info/sct`
Direct Reference Code | Display: Hospice care [Minimum Data Set] Code: 45755-6 System: `http://loinc.org`
Direct Reference Code | Display: Yes (qualifier value) Code: 373066001 System: `http://snomed.info/sct`
Direct Reference Code | Display: Active Code: active System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Direct Reference Code | Display: Recurrence Code: recurrence System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Direct Reference Code | Display: Relapse Code: relapse System: `http://terminology.hl7.org/CodeSystem/condition-clinical`
Dependencies
Dependency | Description: QICore model information Resource: http://hl7.org/fhir/Library/QICore-ModelInfo Canonical URL: `http://hl7.org/fhir/Library/QICore-ModelInfo`
Dependency | Description: Library SDE Resource: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 Canonical URL: `https://madie.cms.gov/Library/SupplementalDataElements|5.1.000`
Dependency | Description: Library FHIRHelpers Resource: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 Canonical URL: `https://madie.cms.gov/Library/FHIRHelpers|4.4.000`
Dependency | Description: Library Status Resource: https://madie.cms.gov/Library/Status|1.15.000 Canonical URL: `https://madie.cms.gov/Library/Status|1.15.000`
Dependency | Description: Library QICoreCommon Resource: https://madie.cms.gov/Library/QICoreCommon|4.0.000 Canonical URL: `https://madie.cms.gov/Library/QICoreCommon|4.0.000`
Dependency | Description: Library Hospice Resource: https://madie.cms.gov/Library/Hospice|6.18.000 Canonical URL: `https://madie.cms.gov/Library/Hospice|6.18.000`
Dependency | Description: Library Antibiotic Resource: https://madie.cms.gov/Library/Antibiotic|1.11.000 Canonical URL: `https://madie.cms.gov/Library/Antibiotic|1.11.000`
Dependency | Description: Library CMD Resource: https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000 Canonical URL: `https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000`
Data Requirements
Data Requirement | Type: Patient Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient Must Support Elements: extension, birthDate, birthDate.value, url
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab Must Support Elements: code, value, status, status.value, effective Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1012
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1073
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1027
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, status, status.value, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, hospitalization, hospitalization.dischargeDisposition, period, status, status.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
Data Requirement | Type: Encounter Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Must Support Elements: type, period, status, status.value Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication, status, status.value, intent, intent.value, authoredOn, authoredOn.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod Code Filter(s): Path: medication ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1001
Data Requirement | Type: MedicationRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest Must Support Elements: medication.reference.value, status, status.value, intent, intent.value, authoredOn, authoredOn.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
Data Requirement | Type: Medication Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication Must Support Elements: id.value, code
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1012
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1025
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1017
Data Requirement | Type: Coverage Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage Must Support Elements: type, period Code Filter(s): Path: type ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
Data Requirement | Type: Observation Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment Must Support Elements: code, value, effective, status, status.value Code Filter(s): Path: code Code(s): http://loinc.org#45755-6: 'Hospice care [Minimum Data Set]'
Data Requirement | Type: ServiceRequest Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest Must Support Elements: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Data Requirement | Type: Procedure Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure Must Support Elements: code, performed, status, status.value Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
Data Requirement | Type: Condition Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns Must Support Elements: code Code Filter(s): Path: code ValueSet: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
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